Provider Demographics
NPI:1144573734
Name:UNIVERSAL SURGICAL PARTNERS
Entity type:Organization
Organization Name:UNIVERSAL SURGICAL PARTNERS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KHALIDA
Authorized Official - Middle Name:
Authorized Official - Last Name:TUFAIL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-655-4141
Mailing Address - Street 1:1 SUGAR CREEK CENTER BLVD STE 850
Mailing Address - Street 2:SUITE 850
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77478-4087
Mailing Address - Country:US
Mailing Address - Phone:832-655-4141
Mailing Address - Fax:713-457-5188
Practice Address - Street 1:1 SUGAR CREEK CENTER BLVD STE 850
Practice Address - Street 2:SUITE 850
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77478-4087
Practice Address - Country:US
Practice Address - Phone:832-655-4141
Practice Address - Fax:713-457-5188
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-19
Last Update Date:2017-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXSA 0277246ZS0410X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246ZS0410XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical TechnologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX320607OtherMEDICARE PTAN
TX0088SXOtherBCBS
TX327288YV3COtherMEDICARE PTAN